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Accurate quantification methods to evaluate cervical cord atrophy in multiple sclerosis patients.

J Carbonell-Caballero1, J V Manjón, L Martí-Bonmatí

  • 1Medical Informatics Area, ITACA-BET, Polytechnic University of Valencia, and Radiology Department, Hospital Quirón, Valencia, Spain. jocarca1@itaca.upv.es

Magma (New York, N.Y.)
|November 23, 2006
PubMed
Summary

Accurate magnetic resonance (MR) imaging techniques are crucial for measuring cervical cord area (CCA) changes in multiple sclerosis (MS) patients. Partial-volume modeling (PVM) with inclination correction offers a reproducible and accurate method for assessing spinal cord atrophy.

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Area of Science:

  • Neuroimaging
  • Quantitative MRI
  • Central Nervous System (CNS) Disorders

Background:

  • Reproducible quantification of cervical cord area (CCA) using magnetic resonance (MR) imaging is essential for assessing central nervous system (CNS) atrophy in multiple sclerosis (MS).
  • Current manual measurement techniques lack the necessary reproducibility for accurate monitoring of disease progression.

Purpose of the Study:

  • To develop and evaluate automatic measurement techniques for CCA quantification.
  • To improve the reproducibility and accuracy of MR imaging-based assessment of spinal cord atrophy in MS patients.

Main Methods:

  • Two segmentation methods were implemented: spatial mean brightness level estimation (SMBLE) and partial-volume modeling (PVM).
  • Methods were evaluated with and without spinal cord inclination and partial-volume effect corrections.
  • Thirty MR studies were used for comparison, with manual segmentation as the reference. A longitudinal study of 15 MS patients and 15 controls evaluated cord atrophy using the best-performing method.

Main Results:

  • Partial-volume modeling (PVM) incorporating spinal cord inclination correction and partial-volume contour estimation demonstrated the highest accuracy.
  • Longitudinal analysis revealed a 4% decrease in CCA among MS patients.
  • No significant reduction in CCA was observed in control subjects.

Conclusions:

  • The automatic PVM cord-segmentation approach, accounting for spinal cord inclination and partial-volume effects, enhances reproducibility and accuracy.
  • This method enables reliable monitoring of spinal cord atrophy changes in MS patients.
  • The findings support the use of this technique for clinical assessment and research in multiple sclerosis.